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Vaccine for kids bandwagon is belatedly on a roll

Politicians are nervous these days about jumping ahead of the evidence, but on this occasion they may have a point

By Richard Hoey

Politicians are nervous these days about jumping ahead of the evidence, but on this occasion they may have a point



Yesterday, the Conservatives did what they have been itching to do for some while, and demanded swine flu vaccines for all children.

Shadow health secretary Andrew Lansley's call for everyone under 24 to have the vaccine follows figures showing a fifth of the UKs swine flu deaths have occurred in the under-15s.

And it's surprising - not that the Tories have pre-empted the evidence-based discussions of the Joint Committee of Vaccination and Immunisation, but that they have taken so long to do so.

After all, their allies at the Telegraph have been grumbling about the exclusion of children from the programme for some while now, and Mr Lansley himself called for the Government to look again at the priority groups more than a month ago.

As bandwagons go, vaccines for our kids is a pretty attractive one, so it's interesting to speculate on what has - until now - prevented the Tories from leaping upon it.

I reckon it's likely to have been the powerful shadow cast by evidence-based medicine. EBM is strong stuff these days, and it doesn't pay to take a decision without suitable referral to systematic review and cost-benefit analysis.

When you've got the time, and the evidence exists, that makes perfect sense. NICE might get a battering for some of its decisions, but few these days question its key role in making decisions on NHS provision on the basis of evidence.

But when a decision has to be made urgently, before there is time to collect evidence together, or before that evidence has been produced in the first place, relying on cost-benefit analysis becomes more problematic.

So back to swine flu. The Government's vaccination advisers plumped to place people in clinical at-risk groups at the front of the queue for vaccination because of their increased relative risk of complications.

Chief medical officer Sir Liam Donaldson leapt on figures showing two thirds of swine flu deaths had occured in the priority groups to justify that decision.

But around 30 kids have died so far from swine flu in the UK, and any death in a child in this country is not only distressing but also very unusual.

Just to put it into perspective, measles, before vaccination was introduced into the UK, killed an average of 85 children a year.

We're already a third of the way there, so it's perhaps not surprising that the vaccines for kids bandwagon is starting to roll.

By Richard Hoey, Pulse editor

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